According to the first-ever Surgeon General's report on oral health in North America (2000), dental caries is the most common chronic childhood disease. In addition, most (75-80%) of the severe caries problems in children in this country occur in a small segment of the population (20-25%), and this problem is particularly prevalent in minorities and immigrants. These affected children are also often found in the lower socioeconomic strata and commonly develop caries at a very early age. Therefore, it is imperative that early in life a child is assessed to identify and eventually treat those children who are at greatest risk for the development of Early Childhood Caries (ECC), preferably before disease development. The purpose of this exploratory study is to develop an innovative self-administered structured caries risk questionnaire to identify toddlers (18-36 months of age) at the highest risk of developing ECC, focusing on at-risk population groups (e.g., African American and Hispanic). The focus will be to identify the caries risk behaviors that the primary caregiver and child have, the impact that their knowledge on oral health has on these factors, and the influence that perceptions of their dental health have on seeking dental care. A range of social, cultural, functional, psychological, socio-demographic, dietary and biological factors that may affect transmission, development of caries, general health, and access to care in these populations will be included. The questionnaire will be developed in three phases. Phase 1 will involve refinement of an initial draft by dental peers and a focus group of target primary caregivers. In Phase 2, this revised version will be then used in a large test population (400 primary caregivers/child pairs). A strength of this proposal is that it will use as the outcome variable for predictive modeling (Phase 3), the detection and 12-month monitoring of early, precavitated caries lesions, using two of the most innovative and sensitive methods for caries detection and monitoring, the International Caries Detection and Assessment System (ICDAS) and the Quantitative Light induced Fluorescence system (QLF), which will allow for a more accurate assessment of disease development and progression over time than traditional level of cavity detection. [unreadable] [unreadable] [unreadable]